La recherche en robotique médicale au Japon

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2005/06/25

Medical Robotics Research in Japan Ichiro Sakuma Biomedical Precision Engineering Lab., Graduate School of Frontier Sciences, The University of Tokyo,


Medical Robotic Study in Japan Powered orthosis study was conducted in 1970s. Application of robotic technology to welfare engineering has long history of research. Surgical Robotics research stared in early In 1980’s. Research group on Computer Aided Surgery (CAS) was formulated in 1987 and the Japan Society of Computer Aided Surgery is established in 1992. New applications are studied in medical robotics.

Funakubo, early 1980

Takakura, Fujie, Dohi, et al.2000 Biomedical Precision Engineering Lab. #2


Academic Activities of Medical robotics Examples: 89 papers among papers 887 papers at 2005 Annual Meeting on Robotics-Mechatronics of Japan Society for Mechanical Engineers, Annual meeting on JSCAS (Japan Society of Computer Aided Surgery) 25/122 in 2003, 30/126 in 2004 Many plenary programs on robotics in medical academic societies such as Endoscopic Surgery Society of Japan, Japan Society of Orthopedic Surgery, and etc.

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Assistive technology and welfare engineering Robotics for rehabilitation Robotics for augment human physical capability Robotics for care Environmental control system

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Welfare robotics

GPS Antenna

Laser Range Sensor

Integrated Control System

Intelligent wheel chair with autonomous traveling ability

6-DOF Rehabilitation Robot for Upper Limbs including Wrists (Furusho et al. 2005, Osaka Univeristy)

(Matsumoto et al 2005, AIST, AISIN SEIKI CO.,LTD, FUJITSU LIMITED

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Commercialized Robotic System for Welfare Engineering

Hitatchi, Walking Rehabilitation Robot

DAIHEN, Patient Transfer Robot Biomedical Precision Engineering Lab. #6


Surgical Robotics Manipulator for Endosopic Surgery Bending forceps based on rigid linkage mechanism rather than wire driven mechanism Incorporation with surgical devices Incorporation with flexible endoscope Miniaturization of the system for neuro/fetus Surgery

Application of Robotic Technologies to surgical navigation Image guidance of surgical robot Robotic technology for minimally invasive precision target therapy. Robotic technology for basic medical research

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Bending forceps based on rigid linkage mechanism フレーム

+90°

+45°

-45°

-90°

Linkage for constraints (blue) Linkage for drive (red)

2 DOF Bending (Yamashita, Dohi 2003) Biomedical Precision Engineering Lab. #8


Master-Slave Combined Manipulator for MIS

Matsuhira, Jinno et al, 2003, Toshiba Co.

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Incorporation with surgical devices

φ 11[mm]

Suzuki, Sakuma et al.: 2004, The Univ. of Tokyo Bending US coagulator/Cutter Nakamura, Iseki, 2004, Tokyo Women’s Medical University Biomedical Precision Engineering Lab. #10


Flexible Endoscope type Robot and Capsule Endoscope

Endoscopic Surgery System Ikuta, 2004, Nagoya Univerisity

Image of Small Intestine

OLYMPUS CO. http://www.olympus.co.jp

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Miniaturization of Bending Forceps

Harada, Fujie 2005, Waseda Univ.

Takakura, Fujie, Dohi, et al. Hitachi, ltd. 2000 Biomedical Precision Engineering Lab. #12


Application of Robotic Technologies to Surgical Navigation

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Image Guided Control of Surgical Robotics

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Puncture of a RFA Needle for Hepatic Tumor under the Navigation System as well as a direct vision with a MR compatible Endoscope Navigation System

Open MRI Endoscopi c View

Manipulator Manipulator for Needle for Endoscope

Polaris for Measurement

Hashizume 2005, Kyushu Univ. Biomedical Precision Engineering Lab. #15


Image Guided Control of Surgical Robot

RFA needle

Needle

Target

Volume Rendering Images

Frame Rate:4s/frame The images are changed at each 4 seconds per frame while following the tip of the needle

Volume rendering images changed as the operator wants

Hashizume 2005, Kyushu Univ. Biomedical Precision Engineering Lab. #16


Precision-guided LASER Surgery System real time segmentation

log 5-ALA 2.8Îź micro-Laser

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Research funding Ministry of Science and Technologies Basic Research of medical robotics Ministry of Economy Trade and Industry Funding for Industries

Ministry of Welfare and Labor Aiming for clinical application of medical robotics

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Problems in medical robotics application Tight regulations by Ministry of Health and Labors DaVinci surgical robot has not been yet approved as medical devices in Japan. Lack of risk assessment capability of medical robotics

Lack of engineering personnel to facilitate use of advanced technologies in hospital Numbers of Ph.D. in engineering at hospitals are still limited in Japan.

Clinical use of medical robotics is still limited because of safety issues and medical insurance coverage.

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Actions for Medical Robotics Acceptance Japan Industrial Robotic Association conducted researches on risk assessment of medical robotics. Academic societies involving medical robotics started discussion on risk assessment and standardization. Ministry of Economy Trade and Industry conducted pilot studies on personal robotics that interacts with human at Aichi EXPO 2005. Ministry of Economy Trade and Industry and Ministry of Health and Labor started to establish guidelines for advanced medical devices for reduction of time and cost for approval as medical devices.

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Summary In Japan, there are many active researches on medical robotics. Research grants are provided by several ministry of government depending on the stage of researches (basic/ industrialization/ clinical). Some commercially available products exists. There is tight regulation by ministry of health and labor. Clinical use of medical robotics is still limited because of safety issues and medical insurance coverage. Establishment of safety guideline and efficacy validation method is required to enhance application of robotics in clinical environment.

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